This article, “Thinking about pregnancy like an economist” in The Atlantic is written by Emily Oster but her observations would be shared by anyone who analyses data in their occupation. When Oster becomes pregnant she quickly notices that public health policy is rather heavy-handed and that many of its strictly enforced rules are based on fairly weak data.
Ultimately, microeconomics is the science of making decisions–a way to structure your thinking so you make good choices. Making good decisions–in business, and in life–requires two things: the right data, and the right way to weigh the pluses and minuses of a decision personally. The key is that even with the same data, this second part–this weighing of the pluses and minuses–may result in different decisions for different people. Individuals may value the same thing differently. Making this decision correctly requires thinking hard about the alternative, and that’s not going to be the same for everyone. This isn’t just one way to make decisions. It is the correct way. So, naturally, when I did get pregnant I thought this was how pregnancy decision making would work, too. Take something like amniocentesis. I thought my doctor would start by outlining a framework for making this decision–pluses and minuses. She’d tell me the plus of this test is you can get a lot of information about the baby; the minus is that there is a risk of miscarriage. She’d give me the data I needed. She’d tell me how much extra information I’d get, and she’d tell me the exact risk of miscarriage. She’d then sit back, Jesse and I would discuss it, and we’d come to a decision that worked for us. This is not what it was like at all.
In reality, pregnancy medical care seemed to be one long list of rules. In fact, being pregnant was a lot like being a child again. There was always someone telling you what to do. It started right away. “You can have only two cups of coffee a day.” I wondered why–what were the minuses? What did the numbers say about how risky this was? This wasn’t discussed anywhere. Then we got to prenatal testing. “The guidelines say you should have an amniocentesis only if you are over thirty-five.” Why is that? Well, those are the rules. Surely that differs for different people? Nope, apparently not (at least according to my doctor). Pregnancy seemed to be treated as a one-size-fits-all affair. The way I was used to making decisions–thinking about my personal preferences, combined with the data–was barely used at all.
But there is something Oster has neglected to notice in her piece. For many women, being pregnant was the first time we ran into a level of paternalism we have until then largely avoided in adulthood. There’s a big, fat gender dimension here and it deserves highlighting. Women’s lives are policed and health policy is just one of the ways in which this is done.
(This link came via Tedra).